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Seeing Near- And a Solution

I was in my late twenties when I first heard the ophthalmologist t say “I can’t correct your vision to 20/20.”

Posted Friday September 15, 2017

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I got my first pair of glasses in the fourth grade. I’m sure my parents were watching for it—I’m the youngest of three, and we’re all near-sighted. When my teacher commented that I had trouble seeing the blackboard, off we went to the optometrist. Blue cat-eye frames. I hated them and loved them—hated having to wear them, but not as much as I loved being able to see well. From the beginning, I wore them every waking moment: no argument. My glasses were the first thing I put on in the morning, and the last thing I took off at night.

At least two pair of my childhood glasses lie on the bottom of the lake in or near Beauty Cove, Lake of the Ozarks. One, for my parents, was totally understandable. I’d said the frames were loose, but Dad hadn’t tightened them up yet. We were in Grandpa’s little motor-boat, putzing around where the cove joined the Lake—and someone with a BIG motor boat zoomed by, with a parasail-skier sailing behind. “Look!” shouted Dad—and I swung around; my glasses swung right off my face and into, what?—probably at least sixty feet of water.

I was miserable without them. My correction wasn’t extreme at that point, but I couldn’t SEE.

The lost second pair was more mundane. We kids, swimming off the dock, left our folded towels on the dock edge. My glasses were on the towel, and I climbed out, picked up my towel, and the glasses landed in the water. We thought about diving for them—maybe only ten feet or so under the dock—but we had helped Grandpa sink dead brushy trees in that water—crappie beds.

My older sister’s eyes are worse than mine (her lenses are so thick she can’t fold the temple hinges), but she, until recently, wore contacts. From the time she was in sixth grade, she wore them without incident. In those days, my parents were told that contacts would help stabilize her deteriorating vision—ah, no. But when we tried contacts for me? sheer misery: I could put them in, but they not only were never comfortable, they hurt.

I’d hide my glasses in my purse and leave the house pretending I was wearing them. Eventually, I was discovered; I endured their disapproval, which lasted until a new optometrist explained that “her eyes are shaped like little footballs, not basketballs. The contacts rested on the points, and didn’t ever make full contact with her eye surface—no wonder they hurt.”

At the time, he recommended specially fitted soft lenses might work, but I’d had enough. I kept my glasses, which got thicker and thicker, every year: the proverbial “coke-bottle” lenses. Eventually, technology improved some, but “ultra-thin” lenses were bottle-thick, too.

Plastic frames gave way to much cooler wire frames, which presented their own problems. The screws loosened, and randomly, if I leaned over, a lens popped out. Mildly annoying, usually, but if I happened to lead over a hard surface (like the bathroom sink), glasses disaster—seeing life for a week or so through a cracked lens while the new one shipped in was only marginally better than having a patch over the empty frame on that side—the weight was wrong, so the frames didn’t balance on my face.

My ex-husband is roughly as far-sighted as I am near-sighted. By this time, we both had stopped going to optometrists, and picked out an ophthalmologist. With new prescriptions in hand, we went to a local glasses-making company in the mall (One Hour Service!), and put the scripts on the counter.

The clerk picked them up and looked at us. “Did you two MEET in the ophthalmologist’s office?” she asked, and then said, “And let me tell you right now, we can’t do lenses like this in house.” A week later, the new glasses came in.

We joked that we’d probably end up with kids who were horribly near-sighted in one eye, and horribly far-sighted in the other. But the kids lucked out—my son has normal vision, my daughter, only a mild correction. Evidentially, genetically, our horrible eyes canceled each other out in our kids.

I was in my late twenties when I first heard the ophthalmologist t say “I can’t correct your vision to 20/20.” I had a few decades of slowed visual decay—no new glasses every year throughout the 80’s, 90’s and into the new millennium. I’ve gone from that horrible glaucoma test where the equipment had to rest against my eye-surface, to the puff of air ones, and the much less invasive whatever-the-technology is now.

As early as the late 1980’s, the optical techs began steering me away from big-frames—too much weight. However, I hate to see the glasses frame in my peripheral vision, so frame selection was a constant balance between size and weight, compounded by my not being able to SEE myself in the frames, at more than ten inches or so from the mirror.

In my mid-fifties, I had a menu of near-sighted person’s eye-issues: astigmatism, cataracts, many floaters (those little ghostly squiggles that randomly drift across my field of vision), and worsening retinas. Twenty or so years ago, the ophthalmologist told me to watch out for bright rings of light in the dark, and, yes, they do show up, and have for at least fifteen years. I was at risk for detached retinas.

In the winter of 2016, something disconcerting happened: Suddenly, rather than the random collection of floaters, I had what appeared to be a soft black snowfall, in both eyes, but worse in my left eye. This persisted for several days, and then cleared away. I’d needed a check-up and new glasses (the lenses had been peeling some coating for a while) but the combination of no insurance and the equivalent of three mortgages and a car-payment held me off from finding a new ophthalmologist in a new town.

When the insurance kicked in, I made an appointment. Technology’s improved again—the doctor showed me pictures of my “paving stone” retinas—roundish and oval holes around the edges of my retinas—those edges have stretched, and thin spots and holes eroded to look like cobblestone pavement (that black snow episode) and actually, in a sense, this diagnosis is positive—my retinas paving stoned instead of detaching.

The end result was that, for about two years, my eyesight was corrected to about 20/40 in both eyes—that’s WITH my glasses on. My eyes focused slowly—by the time I could read a street-sign, I was long past it, unless I’d slowed to a crawl, which inhibits traffic. The blur line started at about a foot and a half, with my glasses. The astigmatism, paired with the cataracts acted as prisms—with either eye or both eyes, I saw items at a distance in triplicate—for example, if I looked at the full moon, I saw three moons that formed a triangle, like the nuclear symbol. I’d see three road signs, and not until I was actually on top of them did the three come together in one image—and that image was still blurred. I’d have only a split second to actually be able to read the sign.

What did this mean? Day to day, watching television was little pleasure: I couldn’t see any text on the screen, nor could I recognize actors’ faces. I worried about driving in strange places, especially in twilight or dark—I’d miss the unfamiliar turn, and have troubles related to details like where curbs start and stop. We live in beautiful country—and I used my camera to bring detail in close enough for me to actually see it. I sat at the computer screen, and leaned in so what I was typing is in focus, hunched over my keyboard, trying to read what I just wrote, my face a foot or less from the computer screen.

I read for pleasure. The book was within my focal length. My visual world shrank, drawn in to what I was able to actually focus on and see.

For about three years, living with this slow-motion decay of sight was an out-of-the-corner-of-my-eye exercise in slow-moving terror. So many questions with no answer—and some I was afraid to ask.

A major concern was that the 20/40 vision prescription is the drivers’ license cut off. I worried about what would happen, if at my next eye examination, the doctor told me that my prescription has gone beyond 20/40 enough that I should no longer drive. The answer would eventually be cataract surgery, but how long would it take for those cataracts to get to the point that insurance would kick in and cover their removal?

After my last eye appointment, when the new prescription didn’t noticeably improve my vision, my doctor made the call: he sent me to a cataract specialist in Rapid City and I was forced to face one of my few phobias: I shudder at the very thought of someone touching my eyes. I can’t even look at the scene in “A Clockwork Orange” where the machine holds Alex’s eyes open. Those glaucoma tests I mentioned earlier always took multiple tries per eye as I worked desperately to cooperate long enough to get the test over. A friend whose macular degeneration requires shots in the eyes… I am sweating and nauseous at the mention. I was torn between recognition of my phobia—and realization that I might finally be able to see clearly again.

I pushed the fear under, and let it alone, and recognized how affected I was by where my vision failed me. Not recognizing people. Not being able to decipher how the road and driveways and parking lots intersect. Not being able to read the fill-in-the-days calendar at work from 10 feet away. Not being able to discern wildlife a field away. Endless failures, endless betrayals by my own body—shortly to come to an end. With the dates set, pre-surgical exams scheduled, and the only decision left which implantable lenses I should get. Underneath the acceptance was stress: I choked at making the lens decision.

Should I opt for the straightforward everything-covered-by-the insurance lenses? Or invest $1900 per eye for lenses that to fix the astigmatism that has created so much havoc in my ability to see? If I were my mother’s age, this wouldn’t be an issue, but at fifty-something, these lenses are in for the rest of my life. When I looked at it that way, the decision became easy: Expense aside, these lenses would fix the most difficult aspect of my vision to control: the astigmatism that meant I saw the moon three times at once, that turned every geometrical object into triplicate. The regular ones would do that, too—but the end result would give me vision closer to 20/20 with the fancy lenses.

The question was—would they actually make how much of a difference? Part of distance seeing is the equipment, the other part is eye-brain reaction, and I’ve never been able to develop those skills.

The surgeries were scheduled six weeks out, so I had lots of time to obsess over every aspect. But once the day for surgery on my left eye arrived, I was more than happy to get it over with. After a couple of eye exams that—as usual—involved holding still, straining to keep my eye opened while staring at a red light in a black field while someone flashed excruciating bright lights in my eye, I went in to be prepped for surgery. I got a gown that went on over my clothes, a big L in magic marker over my left eye, an IV, one of those automated blood pressure cuffs that measure BP every 5 minutes, and I lost count of how many drops went into my left eye (I estimate they had to dilate the surgical eye to the size of a dinner plate). Eventually, the anesthesiologist started the “keep me calm and relaxed” drugs into the IV, and I was wheeled in to get the old lens broken up (by laser) and removed. This left the only visible sign of the surgery—essentially, they use suction pressure to lift the surface to vacuum out the old lens, so I had a ring of tiny red blood vessels around my iris.

Then they wheeled me to the next room and inserted and positioned the new lens. I don’t know how long the whole thing took (no jewelry, no watch), but waiting for the eye drops to kick in took way longer than the actual surgery, and the blood pressure cuff was the most uncomfortable part of it. Once they removed the sterile field that kept my eye opened and kept the site clean, back in Recovery, I amused myself while the nurse went to get my spouse by opening and closing each eye: Left eye open—look at hand held 18 or so inches from my face—IN FOCUS! Right eye open—look at hand… OUT OF FOCUS!

No post surgical pain—a little itchy. I went home and took a nap and puttered around the house, trying to figure out which eye to look out of to see what. By the surgical recheck the next morning, I was tested at 20/25 for that eye. I was back at work the next day, not wearing glasses at all, and the stress was all directed at having the next surgery NOW—do I HAVE to wait ten days? Yes, I did.

I was surprised to discover that the second surgery, while just as quick and non-invasive for me—was actually a very different experience: I both saw and remember more detail—in part because it’s a repeat, but also because with one eye fixed, I was actually seeing more of what was going on with my good eye.

The result? At fifty-seven, after wearing glasses since I was nine years old, I see far better without glasses than I could be corrected to prior to surgery. In eleven days, I want from not being able to be corrected past 20/40 to not wearing glasses at all.

In fact, shortly after my surgery, I stepped into the shower and noticed I could actually read the shampoo bottles—and tried to take my glasses off.

I’ve had the final surgery-related exam now—and for night driving or when my eyes are tired, I have a minimum correction: the important thing, though is that I simply haven’t been able to see this well for decades—for longer than I can actually remember. Folks mention not noticing my pretty blue eyes before—but for me, that’s beside the point: I’m now experiencing something I haven’t had since childhood: normal vision.

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